CIHR Café Scientifique sheds light on brain plasticity

The ability to rewire the brain offers hope to mental health patients

Imagine if there was a way to stem a flood of depressive thoughts. Turn off unhealthy anxiety. Ward off brain atrophy. Or even prevent psychotic episodes—all by targeting the specific brain pathways that lead to these events.

The potential for this, and more, is in the future—and was the focus of a Café Scientifique hosted by CAMH and the Canadian Institutes of Health Research (CIHR) on February 19 at the Gladstone Hotel in Toronto.

The room was filled with more than 80 guests who were there to have a discussion on brain plasticity: the ability for the brain to be “rewired,” and the implications for mental health. Panelists included Dr. Albert Wong a neuroscientist and staff psychiatrist in the Schizophrenia Division at CAMH, Dr Tarek Rajji, Chief of Geriatric Psychiatry at CAMH, and Marie Asuncion, mental health spokesperson and advocate. The Café was moderated by Mary Alberti, CEO of the Schizophrenia Society of Ontario.

What does it mean to rewire the brain?

There are two types of brain plasticity, according to Dr. Wong. The first is developmental. Trillions of neurons grow in conjunction with a person’s physical structure; as your arm grows, for example, so do the neurons responsible for its use. While researchers have figured out how to grow neurons, connecting them with their intended destination is another story. In the case of mental health symptoms, the broad goal of research would be to figure out how to target neurons linked to appropriate brain functions, without affecting the rest of the brain.

Until then, researchers like Dr. Tarek Rajji are focusing on clinical and psychosocial approaches to understand and enhance neuroplasticity, and figure out the best way to treat impaired areas of the brain in mental illness. This involves the second type of brain plasticity: experiential.

The brain changes with every new experience, behaviour or emotion. Its ability to code information is incredibly sophisticated. “The brain responds to exercise, to social stimulation,” adds Rajji. “It changes when we use it, like a muscle.”

This is not news, per se. A classic example can be found in music. People are born with a baseline level of talent, but become good and even excellent through extensive practice. This idea naturally extends to other areas. Mainstream media are now touting the benefits of practicing yoga and meditation to “quiet the mind” and relieve anxiety, depression, and even physical complaints.

But the kind of experiential plasticity that is the focus of current brain research involves targeting thinking processes that we may not control—those inherent to mental illness. “The vast majority of activity in the brain or body is subconscious—we are not aware of what is going on,” explains Dr. Wong.

To counter that obstacle, Dr. Rajji studies the use of non-invasive brain stimulation techniques to enhance neuroplasticity and improve specific mental health symptoms related to illnesses including depression, schizophrenia, and Alzheimer’s disease. He uses electroencepholography to capture data and monitor neural behavior, with the ultimate goal of reconfiguring neural pathways in the brain that are involved in mental illness.

He also studies a psychosocial program for late-life schizophrenia, which includes computerized “brain training” to improve memory and enhance problem solving skills. Like a musician who improves with structured practice, this approach has led to tangible improvements.

Ultimately, combining brain stimulation techniques (which “prime” the brain) with psychosocial interventions may be the approach that ultimately leads to healthier neurological responses.

But how does this affect patients currently experiencing mental health issues?

Neuroplasticity in the real world

When Marie Asuncion was a young girl, she was healthy, happy, and hard-working—until she began hearing voices. Unsure of what she was experiencing, she kept to herself and tried to sort through her feelings on her own. The voices triggered depression and deep paranoia, and she began to smell fire during times of heightened stress, driving her to desperation.

When the voices began telling her she was going to hurt her mother, Asuncion finally broke down and told her parents. They rushed her to hospital, where she was immediately granted access to an on-call psychologist at the Hospital for Sick Children who referred her to CAMH. At the age of 15 she was diagnosed with first-episode psychosis.

Medication, therapy, and a strong support system allowed her to graduate high school, study music at university, and experience friendships and relationships. “But every so often I’d relapse.” After many episodes of psychosis she was diagnosed with schizophrenia.

Her story reflects the experiences of thousands of Canadians, and brought an important perspective to the Café Scientifique.

For health researchers, patients like Asuncion provide the motivation for scientists to continue doing what they do, both Dr. Wong and Dr. Rajji emphasized. For the audience, understanding her experiences shed light on the ultimate goals of the researchers. Research into neuroplasticity may help schizophrenia patients shut out fictional voices, for example. Understanding how genes vary in response to certain external stressors, such as trauma, can help create directed treatment.

“Many things that help people develop and live well, mentally and physically, are well known,” says Dr. Wong. “But problems like poverty, deprivation and trauma, while obvious, are hard to solve. Understanding how to enhance function in certain domains of the brain is a clinical and scientific challenge.”

To that end, “rewiring is a theme of hope,” says Dr. Rajji. “We’ve made advances—we have better tools. The potential is huge.”​